Heart disease is the number one cause of death among women, but the true extent of its death reach is staggering.

Cardiovascular disease claims the lives of one out of every three women, more than the next six causes of death combined. Each year, more than 500,000 women die from heart disease, compared with 40,000 who die from breast cancer. Here in South Carolina, about 7,000 women die of cardiovascular disease every year.

Yet most women are unaware that heart disease is the greatest threat to their health. Fewer than half the women surveyed in a recent American Heart Association poll recognized heart disease as the leading killer of women. Nearly four times as many feared cancer more than heart disease.

"In the past, America focused a lot on prevention of heart disease in men, but not in women," says Laura Herbert, RN, BS, director of Providence Women's Heart Center. "Many of the earlier studies on heart disease didn't even include women."

As new research has become available, it's clear that heart disease symptoms can differ in women and men.

Dr. Norma M. Khoury, a Providence cardiologist with South Carolina Heart Center, explains, "A sensitivity to the often-subtle symptoms of heart disease in women is vitally important in leading women to seek treatment. Equally important is knowing your risk for heart disease."

Risk factors include family history, diabetes, hypertension, high cholesterol, smoking, obesity, age and inactive lifestyle.

"Women tend to be about 10 years older than men when they develop heart disease, and they die more often," says Laura. "Their symptoms can sometimes be vague - fatigue, anxiety, sleep problems and nausea for up to a month prior to a heart attack - so they may not be screened as aggressively as men are.

"Even women's arteries are different," she says. "Cardiovascular disease in women tends to affect smaller, more diffuse vessels instead of the big vessels around the heart. That makes heart disease more difficult to diagnose and treat in women."

Earlier this year, the American Heart Association released its new Guidelines for Preventing Cardiovascular Disease in Women.

The new recommendations include:

Engaging in at least 30 minutes of moderate-intensity physical activity, such as brisk walking, on most days of the week.

Eating an abundance of fruits and vegetables, whole grains and high-fiber foods each day, and eating fish twice a week.

Taking a daily aspirin for women at high risk and healthy women over age 65.

Screening for two chronic illnesses, depression and diabetes, because of their strong connection to heart disease.

"Depression is a powerful independent risk factor for heart disease," Laura says. "A great benefit can also be gained from these guidelines for delaying or preventing diabetes, since women with diabetes are nine times more likely to have a heart attack than those who don't have diabetes.

"It's part of our mission at Providence to not only diagnose and treat heart disease in women, but to try to prevent it from happening in the first place."

To learn more about heart disease in women and Providence Women's Heart Center, please visit RedDressCampaign.com or call 803-256-5560.